Provider Demographics
NPI:1871489914
Name:HOLM, KINLEY JOELLE
Entity type:Individual
Prefix:
First Name:KINLEY
Middle Name:JOELLE
Last Name:HOLM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 R AVE APT E1
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-2315
Mailing Address - Country:US
Mailing Address - Phone:402-320-6179
Mailing Address - Fax:
Practice Address - Street 1:1709 W 39TH ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-8230
Practice Address - Country:US
Practice Address - Phone:308-440-4062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist